RxResults Launches Specialty Drug Management to Mitigate Rising Pharmacy Benefit Costs for Employers

It is no secret that healthcare costs in the United States are out of control. Specialty drugs are proving to be a primary contributor to the expense. That is why the pioneering Pharmacy Benefits Risk Management company, RxResults, is proud to announce the launching of a new product: Specialty Drug Management.

​​​​It's no secret that healthcare costs in the United States are out of control. Specialty drugs are proving to be a primary contributor to the expense.

  • Specialty drug treatment regimens can reach upward of $750,000 per year.
  • The cost of specialty drugs is expected to increase by 63% before 2016 with a steady increase each year expected through 2023.
  • 70% of the drugs approved by the FDA in 2014 were in the specialty category.
  • Specialty drugs are breakthroughs in science and are usually a live organism, which leads to administration and tolerance difficulties.
  • Most specialty drugs do not have generic, biosimilar or lower cost alternatives.
  • Outcomes are sometimes unknown, or less than concrete, however, companies like Novartis realize they must move toward a pay for outcomes reimbursement model. (source)

That is why the pioneering Pharmacy Benefits Risk Management company, RxResults, is proud to announce the launching of a new product: Specialty Drug Management.​

Most employers know little about what makes a drug a specialty drug, but most do know the costs are rising astronomically. The industry is predicting that specialty drugs may be the primary cause of rising medical costs over the next few years. Without a proactive approach to managing these dollars, employers will experience an exponential rise in cost year after year.

Tery Baskin, President and CEO, RxResults

Tery Baskin, President and CEO of RxResults says: ”Members expect their employers to cover these expensive drugs because national celebrities are endorsing them.  Our television programming is inundated with drug advertisements, some of which are specialty drugs, all of which are very expensive.  Yet the public has little knowledge of the cost of these drugs.  More importantly, we know very little about the outcomes we can expect. The RxResults Specialty Drug Management Product is designed to help members understand when the drug is right for them and provide the support needed to deal with administration and tolerance difficulties. Avoiding one administration of these high cost drugs can mean thousands of dollars to the employer. The most important thing employers need to know is that these drugs will continue to hit the market and we will have to continue with research in order to make the right decisions about when these drugs are appropriate.”

RxResults is uniquely positioned to manage specialty drugs for participating members. Through their relationship with University of Arkansas for Medical Sciences (UAMS) College of Pharmacy, RxResults can provide additional research on outcomes, manage the accelerating costs and help keep people in business.  This product will help employers:

  • By providing prior authorization services to make sure the right members that meet the right clinical criteria; get the right drugs at the right time in order to attain the best health.
  • By providing analytics to help employers understand where the money is being spent.
  • By providing assistance with benefit design to be sure the coverage criteria for specialty drugs is Evidence-based.
  • By providing cost controls in the form of fee schedules and other unique mechanisms such as negotiation with pharmaceutical manufacturers to pay for drugs on an outcome basis.
  • By providing outstanding Member support to assist with tolerance and adherence difficulties.

Dr. Baskin goes on: ”Most employers know little about what makes a drug a specialty drug, but most do know the costs are rising astronomically.  The industry is predicting that specialty drugs may be the primary cause of rising medical costs over the next few years. Without a proactive approach to managing these dollars, employers will experience an exponential rise in cost year after year.  With drug manufacturers spending millions on advertising and offering the distributors (often PBM’s) incentives to promote the drug, you need an unbiased organization to help protect you and your members.  With support, you can be sure the drugs approved for use will bring your members to better health and could save money in the long run.”

Through an evidence based medicine approach, RxResults can provide clinically sound, member-centered and cost effective prescription benefits.   RxResults Specialty Drug Management program is poised to revolutionize the way specialty drug costs are managed.

About RxResults:

RxResults, a proven industry leader in Pharmacy Benefits Risk Management, provides their clients with a comprehensive suite of sophisticated, informatics-powered, evidence-based clinical tools that meaningfully reduce the cost and improve the quality of their pharmacy benefits for both the employer and their members. When necessary, the RxResults Suite of Solutions provides seamless integration with your Pharmacy Benefit Manager (PBM) within the framework of your current plan design. RxResults products are available as stand-alone solutions or a full suite and are easily embedded into branded or private-label versions. Learn more at www.rxresults.com.

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Categories: Healthcare, Insurance, Pharmaceuticals and Biotech

Tags: ACA, cost containment, healthcare, pharmacy, pharmacy risk management


About RxResults

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RxResults is a next-generation Pharmacy Benefits Risk Management company providing a comprehensive suite of evidence-based clinical tools that reduce the cost and improve the quality of their pharmacy benefits for both the payer and their members.

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